Provider Demographics
NPI:1144511841
Name:MIELKE, LAUREN (RN-BSN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MIELKE
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 DALE ST SW
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-5021
Mailing Address - Country:US
Mailing Address - Phone:320-583-5333
Mailing Address - Fax:
Practice Address - Street 1:1125 DALE ST SW
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-5021
Practice Address - Country:US
Practice Address - Phone:320-583-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 200520-7163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse